TY - JOUR
T1 - Evaluation of the Implementation of FDG-PET/CT and Staging Laparoscopy for Gastric Cancer in The Netherlands
AU - Gertsen, Emma C.
AU - Borggreve, Alicia S.
AU - Brenkman, Hylke J. F.
AU - Verhoeven, Rob H. A.
AU - Vegt, Erik
AU - van Hillegersberg, Richard
AU - Siersema, Peter D.
AU - On behalf of the Dutch Upper Gastrointestinal Cancer Audit (DUCA) group
AU - Ruurda, Jelle P.
N1 - Funding Information: Relevant financial activities outside the submitted work: Peter D. Siersema receives research support from EllaCS (Czech Republic) and Pentax (Japan). Rob H.A. Verhoeven has received research grants from Bristol-Myer Squibb and Roche. Emma C. Gertsen, Alicia S. Borggreve, Hylke J.F. Brenkman, Erik Vegt, Richard van Hillegersberg, and Jelle P. Ruurda have no disclosures to declare. Publisher Copyright: © 2020, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Background: The role of 18F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG-PET/CT) and staging laparoscopy (SL) has increased in the preoperative staging of gastric cancer. Dutch national guidelines have recommended the use of FDG-PET/CT and SL for patients with locally advanced tumors since July 2016. Objective: The aim of this study was to evaluate the implementation of FDG-PET/CT and SL in The Netherlands. Methods: Between 2011 and 2018, all patients who underwent surgery for gastric cancer were included from the Dutch Upper GI Cancer Audit. The use of FDG-PET/CT and SL was evaluated before and after revision of the Dutch guidelines. Outcomes included the number of non-curative procedures (e.g. palliative and futile procedures) and the association of FDG-PET/CT and SL, with waiting times from diagnosis to the start of treatment. Results: A total of 3310 patients were analyzed. After July 2016, the use of FDG-PET/CT (23% vs. 61%; p < 0.001) and SL (21% vs. 58%; p < 0.001) increased. FDG-PET/CT was associated with additional waiting time to neoadjuvant therapy (4 days), as well as primary surgical treatment (20 days), and SL was associated with 8 additional days of waiting time to neoadjuvant therapy. Performing SL or both modalities consecutively in patients in whom it was indicated was not associated with the number of non-curative procedures. Conclusion: During implementation of FDG-PET/CT and SL after revision of the guidelines, both have increasingly been used in The Netherlands. The addition of these staging methods was associated with increased waiting time to treatment. The number of non-curative procedures did not differ after performing none, solely one, or both staging modalities.
AB - Background: The role of 18F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG-PET/CT) and staging laparoscopy (SL) has increased in the preoperative staging of gastric cancer. Dutch national guidelines have recommended the use of FDG-PET/CT and SL for patients with locally advanced tumors since July 2016. Objective: The aim of this study was to evaluate the implementation of FDG-PET/CT and SL in The Netherlands. Methods: Between 2011 and 2018, all patients who underwent surgery for gastric cancer were included from the Dutch Upper GI Cancer Audit. The use of FDG-PET/CT and SL was evaluated before and after revision of the Dutch guidelines. Outcomes included the number of non-curative procedures (e.g. palliative and futile procedures) and the association of FDG-PET/CT and SL, with waiting times from diagnosis to the start of treatment. Results: A total of 3310 patients were analyzed. After July 2016, the use of FDG-PET/CT (23% vs. 61%; p < 0.001) and SL (21% vs. 58%; p < 0.001) increased. FDG-PET/CT was associated with additional waiting time to neoadjuvant therapy (4 days), as well as primary surgical treatment (20 days), and SL was associated with 8 additional days of waiting time to neoadjuvant therapy. Performing SL or both modalities consecutively in patients in whom it was indicated was not associated with the number of non-curative procedures. Conclusion: During implementation of FDG-PET/CT and SL after revision of the guidelines, both have increasingly been used in The Netherlands. The addition of these staging methods was associated with increased waiting time to treatment. The number of non-curative procedures did not differ after performing none, solely one, or both staging modalities.
UR - http://www.scopus.com/inward/record.url?scp=85090432369&partnerID=8YFLogxK
U2 - https://doi.org/10.1245/s10434-020-09096-z
DO - https://doi.org/10.1245/s10434-020-09096-z
M3 - Article
C2 - 32901312
SN - 1068-9265
VL - 28
SP - 2384
EP - 2393
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 4
ER -